Rush Hymenoptera Venom Immunotherapy in Thai Children

Abstract

RATIONALE: The rush hymenoptera venom immunotherapy (VIT) has been shown to be safe and effective, but it is not commonly practiced in Thailand. We examined the efficacy and safety of rush VIT and the risk factors in these patients. METHODS: A 3-year retrospective study was done which revealed 11 patients with history of severe systemic reaction after being stung by hymenoptera. Diagnosis was made on the basis of history and evidence of sensitization by positive skin testing and/or presence of specific IgE to honeybee, vespid or fire ant venom. They all received rush VIT regimen with a careful monitoring of adverse reaction in Ramathibodi hospital, a referral center for insect venom allergy. We evaluated risk factors for serious adverse reaction such as age, gender, atopic history, severity of insect sting reaction according to the H.L. Muller classification, and evidence of sensitization. RESULTS: There were 4 patients treated with honeybee, 5 with fire ant, one with mixed vespid and one with mixed vespid plus honeybee immunotherapy. All patients are male. Adverse reactions were observed in 4 patients (36%) with mild severity (1 with large local reaction, 3 with generalized urticaria but no other systemic reaction), and were not associated with age, type of hymenoptera allergen used, level of sensitization (either by skin testing or specific IgE) and atopic history. CONCLUSIONS: Rush hymenoptera venom immunotherapy is an alternative treatment for patients who are in active life styles especially children and adolescents. No serious adverse reaction with rush VIT was seen in our study.